Description: The studies in this core address 1) how financing and organizational incentives affect access to care, service utilization and quality of care, and 2) how benefit design and health policy changes influence the level, mix and quality of health and mental health services for persons with severe mental illness. The goal is to improve understanding of the processes that lead to access to needed services by seriously mentally ill individuals. The understanding is to be developed via a health services approach of examining the real-world relationships between financial and organizational structures and services provided by types of providers to classes of people. Focal themes are: 1) the roles of general medical and specialist mental health (MH) sectors in mediating access to care, 2) the effect of structures of managed behavioral care, and 3) the factors that affect who receives costly treatments.